January 19, 2022

News

News Network

William M. Kelly, M.D., Inc And Omega Imaging, Inc. Agree To Pay $5 Million To Resolve Alleged False Claims For Unsupervised And Unaccredited Radiology Services

12 min read
<div>William M. Kelly Inc. and Omega Imaging Inc., together, operate 11 radiology facilities in Southern California, have agreed to pay the United States $5 million to resolve allegations that they violated the False Claims Act (FCA) by knowingly submitting claims to Medicare and the military healthcare program, TRICARE, for unsupervised radiology services and services provided at unaccredited facilities, the Department of Justice announced today.</div>

William M. Kelly Inc. and Omega Imaging Inc., together, operate 11 radiology facilities in Southern California, have agreed to pay the United States $5 million to resolve allegations that they violated the False Claims Act (FCA) by knowingly submitting claims to Medicare and the military healthcare program, TRICARE, for unsupervised radiology services and services provided at unaccredited facilities, the Department of Justice announced today.

“Today’s settlement demonstrates the department’s unrelenting commitment to protect the public fisc and patient safety,” said Acting Assistant Attorney General Jeffrey Clark of the Department of Justice’s Civil Division.  “The department will aggressively pursue unscrupulous healthcare providers who cut corners that could jeopardize the health and safety of Medicare and TRICARE beneficiaries.” 

“Patients rightly expect that medical providers follow the proper procedures and protocol when administering complex treatments to ensure patient safety,” said Timothy B. DeFrancesca, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.  “Working with our law enforcement partners we remain steadfast in our commitment to uphold the integrity of government health programs.”

The settlement resolves allegations that the defendants submitted claims for CT scans and MRIs involving contrast injections that were not properly supervised by a physician.  Applicable program rules require a physician to be present in the office suite when a patient undergoes an examination that involves the administration of intravenous contrast material.  The defendants allegedly performed and billed for these procedures when no supervising physician was present in the office suite.  The settlement also resolves allegations that a certain number of the defendants’ facilities lacked accreditation.

Contemporaneous with the settlement, William M. Kelly, Inc. and Omega Imaging Inc. entered into a three-year Integrity Agreement (IA) with the Department of Health and Human Services Office of Inspector General requiring, among other things, the implementation of a risk assessment and internal review process designed to identify and address evolving compliance risks.  The IA requires training, auditing, and monitoring designed to address the conduct alleged in the case.

The settlement, which was based on the defendants’ ability to pay, resolves allegations originally brought in a lawsuit filed under the qui tam, or whistleblower, provisions of the FCA by Syd Ackerman, who was formerly employed by the defendants.  The FCA permits private parties to sue on behalf of the government for false claims and to receive a share of any recovery.  The FCA permits the United States to intervene in such a lawsuit, as it did in part here.  Mr. Ackerman will receive approximately $925,000 of the settlement proceeds.

This settlement was the result of a coordinated effort by the Civil Division’s Commercial Litigation Branch; the Department of Health and Human Services, Office of Counsel to the Inspector General and Office of Investigations; the Defense Criminal Investigative Service; and the Defense Health Agency Office of General Counsel. 

The qui tam case is captioned United States ex rel. Syd Ackerman v. William M. Kelly, M.D., Inc. and Omega Imaging, Inc., No. EDCV 13-02195 JGB (DTBx) (C.D. Cal.). 

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

News Network

  • Fourteenth Anniversary of Robert “Bob” Levinson’s Abduction
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Examining Facilitating Factors for Safe, Voluntary, and Sustained Post-Conflict Refugee Returns (RAND Corporation)
    In Human Health, Resources and Services
    Bureau of Population, [Read More…]
  • Owner of Tax Preparation Business Sentenced to Prison for Filing False Returns
    In Crime News
    A former Gulfport, Mississippi, tax return preparer was sentenced to 46 months in prison today for aiding and assisting in the preparation of false returns, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division and U.S. Attorney Mike Hurst for the Southern District of Mississippi.
    [Read More…]
  • Peruvian National Sentenced to Over 9 Years in Prison for Defrauding Thousands of Spanish-Speaking U.S. Immigrants
    In Crime News
    More from: September 21, [Read More…]
  • Four MS-13 Members Indicted for 10 Murders, Kidnapping and Racketeering Charges
    In Crime News
    Four alleged members of La Mara Salvatrucha (MS-13) have been charged in a federal superseding indictment with a racketeering conspiracy involving multiple murders, kidnappings and burglaries, as well as drug trafficking.
    [Read More…]
  • North Carolina Man Pleads Guilty to Production of Child Pornography
    In Crime News
    A North Carolina man pleaded guilty Monday to production of child pornography. 
    [Read More…]
  • Joint Statement on the U.S.-Israel Economic Development Group
    In Crime Control and Security News
    Office of the [Read More…]
  • Deputy Attorney General Lisa Monaco Announces Creation of New Cyber Fellows Positions
    In Crime News
    Today, Deputy Attorney General Lisa Monaco announced the creation of a new Cyber Fellowship program, designed to develop a new generation of prosecutors and attorneys equipped to handle emerging national security threats.
    [Read More…]
  • Foreign national found guilty of smuggling over $1M in meth
    In Justice News
    A Laredo federal jury [Read More…]
  • Fiscal Year 2013 Budget Request: U.S. Government Accountability Office
    In U.S GAO News
    This testimony discusses the U.S. Government Accountability Office’s (GAO) budget request for fiscal year (FY) 2013. GAO very much appreciates the confidence Congress has shown in the efforts to help support the Congress in carrying out its constitutional responsibilities and to help improve government performance and accountability for the benefit of the American people.GAO is requesting an appropriation of $526.2 million for FY 2013 to support a staffing level of 3,100. This funding level represents a modest increase of 2.9 percent over FY 2012, and is 5.4 percent below our FY 2010 level. The majority of the requested increase represents the first step in rebuilding our staff capacity to a level that will enable us to optimize the benefits we yield for the Congress and the nation.We have carefully reviewed every aspect of our operations from a zero base to identify opportunities to reduce costs without sacrificing the quality of our work and preserving our ability to assist the Congress in addressing the most important priorities facing the nation. However, given that staff costs now represent about 81 percent of our budget and the deep reductions already taken in our infrastructure programs, reducing the size of our workforce could not be avoided. By the end of FY 2012, for the first time in over 75 years, GAO’s staffing level will drop below 3,000 staff, resulting in a net reduction of 11 percent in our staff capacity, or 365 people, in only a 2-year period.GAO’s work directly contributes to improvements in a broad array of federal programs affecting Americans everywhere and remains one of the best investments across the federal government. With this committee’s support, in FY 2011, GAO provided assistance to every standing congressional committee and about 70 percent of their subcommittees. GAO issues hundreds of products annually in response to congressional requests and mandates. Our work yielded significant results across the government, including financial benefits of $45.7 billion—a return on investment of $81 for every dollar invested in GAO. Our findings and recommendations produce measurable financial benefits for the federal government, enabled through the actions of Congress and Executive Branch agencies, ultimately making funds available to reduce government expenditures, reallocate funds to more productive areas, or increase revenues.
    [Read More…]
  • Justice Department Sues to Block Visa’s Proposed Acquisition of Plaid
    In Crime News
    Today, the Department of Justice filed a civil antitrust lawsuit to stop Visa Inc.’s $5.3 billion acquisition of Plaid Inc. Visa is a monopolist in online debit services, charging consumers and merchants billions of dollars in fees each year to process online payments.  Plaid, a successful fintech firm, is developing a payments platform that would challenge Visa’s monopoly. 
    [Read More…]
  • Texas Sport Supplement Company Owner Pleads Guilty to Unlawful Distribution of Steroid-Like Drugs
    In Crime News
    A former Texas resident and his sport supplement company pleaded guilty today to a felony charge relating to the introduction of unapproved new drugs into interstate commerce, the Department of Justice announced.
    [Read More…]
  • Priority Open Recommendations: Department of Housing and Urban Development
    In U.S GAO News
    What GAO Found In April 2020, GAO identified 17 priority recommendations for the U.S. Department of Housing and Urban Development (HUD). Since then, HUD has implemented 5 of those recommendations by, among other things, taking actions to help HUD strengthen the monitoring of disaster recovery block grant funds and improving information technology management. In June 2021, GAO identified 1 additional priority recommendation for HUD, bringing the total number to 13. This recommendation involved improving the Real Estate Assessment Center's physical inspection process. The 13 recommendations fall into the following areas: Improve Real Estate Assessment Center's physical inspection process Address Ginnie Mae's risk management and staffing-related challenges Strengthen processes to address lead paint hazards Enhance oversight of Moving to Work Improve cybersecurity risk management and workforce planning practices Improve information technology management HUD's continued attention to these issues could lead to significant improvements in government operations. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact John Pendleton at (202) 512-8678 or pendletonj@gao.gov.
    [Read More…]
  • Defense Ammunition: DOD Meeting Small and Medium Caliber Ammunition Needs, but Additional Actions Are Necessary
    In U.S GAO News
    Following the end of the Cold War, the Department of Defense (DOD) significantly reduced its purchases of small and medium caliber ammunition and reduced the number of government-owned plants that produce small and medium caliber ammunition. Since 2000, however, DOD's requirements for these types of ammunition have increased notably. Because the success of military operations depends in part on DOD having a sufficient national technology and industrial base to meet its ammunition needs, Congress asked GAO to review DOD's ability to assess if its supplier base can meet small and medium caliber ammunition needs. Specifically, we (1) identified changes over the past several years that have increased the requirement for small and medium caliber ammunition, (2) assessed the actions DOD has taken to address the increased requirement, and (3) determined how DOD plans to ensure that it can meet future small and medium caliber ammunition needs.DOD's increased requirements for small and medium caliber ammunition over the past several years are largely the result of increased weapons training requirements needed to support the Army's transformation to a more self-sustaining and lethal force--an effort accelerated after the terrorist attacks of September 11, 2001--and the deployment of forces to conduct recent U.S. military actions in Afghanistan and Iraq. Between fiscal years 2000 and 2005, total requirements for small caliber ammunitions more than doubled, from about 730 million to nearly 1.8 billion rounds, while total requirements for medium caliber ammunitions increased from 11.7 million rounds to almost 22 million rounds. DOD has initiated several steps to meet the increased demand, including funding about $93.3 million for modernization improvements at the three government-owned ammunition plants producing small and medium caliber ammunition. DOD is currently able to meet its medium caliber requirement through modernization efforts at the government-owned ammunition plants and through contracts with commercial producers. The government-owned plant producing small caliber ammunition cannot meet the increased requirements, even with these modernization efforts. Also, commercial producers within the national technology and industrial base have not had the capacity to meet these requirements. As a result, DOD has had to rely at least in part on foreign commercial producers to meet its small caliber ammunition needs. DOD has taken steps to ensure that the national technology and industrial base can meet future small caliber ammunition needs by building flexibility into the acquisition system to address fluctuations. In addition, a planning process has been put in place to ensure that the base can respond to longer-term DOD ammunition needs, including small and medium caliber ammunition. While the process is ongoing, information to effectively implement the plan and timely performance measures to ensure accountability are lacking.
    [Read More…]
  • United States Files Suit Against California Skilled Nursing Chain and its Owner for Allegedly Paying Illegal Kickbacks to Physicians
    In Crime News
    The United States filed a complaint in the U.S. District Court for the Central District of California yesterday under the False Claims Act against Paksn Inc.; Prema Thekkek, one of its owners; and seven skilled nursing facilities (SNFs) owned by Thekkek and/or operated by Paksn. Those seven SNFs are Bay Point Healthcare Center, Gateway Care & Rehabilitation Center, Hayward Convalescent Hospital, Hilltop Care & Rehabilitation Center, Martinez Convalescent Hospital, Park Central Care & Rehabilitation Hospital, and Yuba Skilled Nursing Center.
    [Read More…]
  • Pennsylvania Doctor Sentenced for Unlawfully Distributing Oxycodone
    In Crime News
    A Pennsylvania man was sentenced today to three years in prison for his unlawful distribution of controlled substances.
    [Read More…]
  • Cameroon man sentenced for wire fraud conspiracy
    In Justice News
    The leader and manager [Read More…]
  • San Benito man sent to prison for robbing bank via threatening message
    In Justice News
    A 26-year-old local man [Read More…]
  • Privacy: Federal Financial Regulators Should Take Additional Actions to Enhance Their Protection of Personal Information
    In U.S GAO News
    What GAO Found The five federal financial regulators GAO reviewed have built more than 100 information system applications that regularly collect and use extensive amounts of personally identifiable information (PII)—information that can be used to locate or identify an individual—to fulfill their regulatory missions. These regulators collect and share PII with entities such as banks or service providers, contractors and other third parties, and other federal and state regulators. The regulators also collect PII directly from individuals and from financial institutions. Regulators use the PII to conduct supervisory examinations of financial institutions and to receive and respond to complaints or inquiries from customers (see figure). Collection, Use, and Sharing of Personally Identifiable Information (PII) at Selected Federal Financial Regulators All five financial regulators have created privacy programs that generally take steps to protect PII in accordance with key practices in federal guidance. For example, regulators fully addressed key practices for establishing privacy programs, conducting privacy training for staff, and implementing incident response procedures. However, four of the regulators did not fully implement key practices in other privacy protection areas. For example, the Board of Governors of the Federal Reserve System (Federal Reserve) and National Credit Union Administration (NCUA) did not maintain a full PII inventory for all agency-owned applications, and did not document steps they took to minimize the collection and use of PII. Also, the Federal Deposit Insurance Corporation (FDIC) and Federal Reserve did not establish agencywide metrics to monitor privacy controls, and the Federal Reserve and the Office of the Comptroller of the Currency (OCC) had not fully tracked decisions by program officials on the selection and testing of privacy controls. Until these regulators take steps to mitigate these weaknesses, the PII they collect, use, and share could be at increased risk of compromise. Why GAO Did This Study Federal financial regulators are agencies that supervise the products provided by financial institutions. As part of their oversight responsibilities, many regulators collect and maintain a large amount of consumers' PII. Increased collection and use of PII by agencies can pose challenges in ensuring the protection of individuals' privacy. GAO was asked to review regulators' handling of PII. This report examines (1) what mission-related PII selected federal financial regulators collect, use, and share, and (2) the extent to which selected regulators ensure the privacy of the PII they collect, use, and share, in accordance with federal requirements and guidance. GAO selected for review five regulators based on their authority to enforce consumer protection laws and the amount of PII they collect. For each of these entities, GAO analyzed privacy documentation to determine methods by which regulators handle PII, and compared regulators' key practices for handling PII to federal guidance. GAO interviewed officials from these regulators on their handling of PII. GAO also reviewed available agency inspector general reports addressing privacy issues.
    [Read More…]
  • Corpus Christi woman gets 30 years for sexual exploitation of a child
    In Justice News
    A 55-year-old local [Read More…]

Crime

Network News © 2005 Area.Control.Network™ All rights reserved.